Prevalence of human respiratory syncytial virus infection in people with acute respiratory tract infections in Africa: A systematic review and meta‐analysis

Abstract

AimThe epidemiology of human respiratory syncytial virus (HRSV) infection has not yet been systematically investigated in Africa. This systematic review and meta‐analysis are to estimate the prevalence of HRSV infections in people with acute respiratory tract infections (ARTI) in Africa.MethodWe searched PubMed, EMBASE, Africa Journal Online, and Global Index Medicus to identify observational studies published from January 1, 2000, to August 1, 2017. We used a random‐effects model to estimate the prevalence across studies. Heterogeneity (I 2) was assessed via the chi‐square test on Cochran's Q statistic. Review registration: PROSPERO CRD42017076352.ResultsA total of 67 studies (154 000 participants) were included. Sixty (90%), seven (10%), and no studies had low, moderate, and high risk of bias, respectively. The prevalence of HRSV infection varied widely (range 0.4%‐60.4%). The pooled prevalence was 14.6% (95% CI 13.0‐16.4, I 2 = 98.8%). The prevalence was higher in children (18.5%; 95% CI 15.8‐21.5) compared to adults (4.0%; 95% CI 2.2‐6.1) and in people with severe respiratory tract infections (17.9%; 95% CI 15.8‐20.1) compared to those with benign forms (9.4%; 95% CI 7.4‐11.5); P‐values <0.0001. The HRSV prevalence was not associated with sex, subregion in Africa, setting, altitude, latitude, longitude, and seasonality.ConclusionThis study suggests a high prevalence of HRSV in people with ARTI in Africa, particularly among children and people with severe clinical form. All innovative strategies to curb the burden should first focus on children which present the highest HRSV‐related burden.

Respiratory syncytial virus in the Western Pacific Region: a systematic review and meta-analysis

“…Based on our study, RSV has a considerable contribution to the WPR as an aetiology of respiratory infection, especially in children less than 5 years. Our analysis of the difference in the RSV positivity rate between children under 5 years and greater than 5 years is concordant with the results from African region [10]. As the specific prevention measure of an RSV vaccine is not yet available, other respiratory infection prevention and control measures targeted at this age group should be implemented in both developed and developing countries.…”

“…The largest population group included in our RSV study is children with acute respiratory tract infections, 159 studies, which show a prevalence higher than the adult group. Our results are similar to previous systematic studies in both developing countries [9,10] and developed countries [43,44]. The prevalence of RSV in adults is still not well-established compared with studies of adult influenza infection and the limited number of studies in adults might contribute to the lower reported prevalence in this age population.…”

“…The previous estimate based just on pneumonia episodes showed a higher RSV prevalence than our result [34]. Our result shows that the RSV-positive rate in both adult and child patients is higher than a previous systematic review of studies in Africa with a pooled prevalence of RSV infection in ARTI cases of 14.6% [10]. However, our RSV pooled prevalence is lower than the prevalence from systematic review studies in Latin America and Iran, where the RSV pooled prevalence was 18.7% and 9.2%-41.5%, respectively [9,35].…”

“…These data are usually limited to a specific location, community or hospital, during a specific time period, and therefore it is often difficult to conclude prevalence figures or estimate their accuracy. Several systematic reviews have tried to determine the burden of RSV infection, especially in children, in different regions in the world [1,8-10]. RSV epidemiological data are required to properly plan resource allocation and public health policies for disease control, particularly when or if a vaccine becomes available.…”

Molecular characterization of respiratory syncytial virus circulating in Tunisia between 2015 and 2018

“…Nonetheless, rates of detection appear to vary largely between published studies from different regions of the world. A meta-analysis realized between 2000 and 2017 including 20 African countries reported a detection rate of 22.6 % among children under the age of 5 years [25]. Ogunsemowo et al .…”